March 23, 2011

Bad At Math

xanax.jpg
how much is this worth

The following story is fiction.  Any similarity to people living or dead is purely coincidental.

The doctor was at work doing the usual, which means patients, and a 20 year old hispanic man bursts through the door and right away the doctor knew he was in big, big trouble.

The man wore sunglasses, the kind of one solid plastic band around the eyes that you don't wear unless you're insane.   He locks the door behind him and shouts, "if you give me any shit, I'm going to fucking kill you." That was his opening line, the next few lines were derivatives of the same.

He was yelling in English, but at about three threats in he says, "I want a translator--" so he opens the door and the secretary (hispanic) that had come to the door to see what the yelling was about steps in, no, he pulls her in, locks the door again, and goes back to yelling.  "You're fucking dead, do you hear me?  Fucking dead!"

One other thing: he has a gun.

Putting it together later, yes, there will be a later, the doctor had seen that man, Juan, once before.  He had demanded Xanax max dose three times a day, and in the subsequent negotiations it was agreed that as long as the guy could provide clean urines he could get one Xanax half dose a day, along with the other medications.  Deal?  Deal.  So he got a script for 14 days, "come back then and we'll see how things are."

Somehow Juan had taken the 14 tablets as a personal insult, he expected 90, even though it was clear that it was only for two weeks, and however he figured it in his brain the doctor was screwing him.  So he came back-- three months later-- looking to show the doctor he messed with the wrong guy.  "You think you're going to play me?"

The room they were in was the size of a large closet, about 8x8 square.  The door opened inwards, then there's a desk, and then the doctor-- so the desk is in between the doctor and the door.  The waiting room is full and it's right outside that door, so everyone can hear the yelling, but no one can see the gun.  Not yet, anyway.

The problem, logistically, was that even if the doctor wanted to jump him, he couldn't-- Juan is  blocking the door, and the desk is between them.  If he comes over to hit him, then they're close, but with that desk in between, the doctor was completely at his mercy.

The other problem, the GIGANTIC problem, is now there's a woman in there with them, and she can't get out because she would have to open the door into herself (she'd end up behind the open door) and then move towards him to get out.

Patients yelling at the doctor to give them Xanax is nothing new-- they threaten, they yell, they posture, and it's all part of the game.  The doctor had always played the game respectfully,  cool, calm, no anger, and he let them, nonverbally, understand that he respected the power that they had-- if they wanted to, they could kill him-- but that the job is the job, nothing personal, you're not getting Xanax not because I hate you but simply because I don't think it's right.  And he let them know that he'd do whatever else he could for them.  Sure some people left angry, but they left. 

And when they yelled he let them, let them go on for so that they felt like they had delivered their message, and eventually cut them off;  ultimately they just need to feel that they chose to let him go, not that they were turned away or rejected but that it was their choice to move on,  and when they left that would be the end.  It happened about once a week to him and all the other doctors, it's just the nature of the business and there's no billing code for "pissed off xanax seeking guy."

But this guy was different, this guy wasn't looking to get something.  This guy came with the specific intention of killing him, he wasn't looking for more xanax or anything else.

And he wasn't psychotic, he was logical, specific-- just very threatening.  "You think I'm playing?"  "I'm going to tell you what's what."  "You think you know me?"  Every gangbanger movie cliche, as if he was reading from a script,  but if that guy stayed true to his character then this was going to end very badly.

So Juan locks them all in, and she's scared, and the doctor is scared.  Because now, with her there, he was completely sure he meant to kill them.   Before she came in, it was between him and Juan only, and he might be able to talk him down, but when Juan brought her in it was clear he wasn't worried about being caught or identified or collateral damage, he just wanted to kill. 

So he yells for about 30 seconds (it felt like an hour) and then the doctor tells him that perhaps he can get him some Klonopin, which is a lot like Xanax.  The Klonopin was incidental to the argument, but he figured that if he could get this maniac to focus on something concrete, turn it into a treatment or at the very least a transaction, in which he could be "given" something, the guy might back down just enough to not kill everyone. 

But the problem was the woman.  She was scared but also... irrational.  Would she try and run?  Would she try something stupid?  Was he going to kill her, too?  He had to get her out.

So the doctor turns to Juan and says, "but I need your insurance card to make sure I can give you Klonopin."  That was a lie, but it was a distraction, turn the focus to something else.    Juan gets his wallet out muttering, "he wants my card now, my card, this fucking (something) wants my card."  And he gives it to the doctor, and the doctor hands it right to the woman and says, "I need a copy of this immediately.  Immediately."  She hesitates, she's unsure, she moves towards the door slowly but Juan lets her pass.  Thank God, he thinks.  It's going to be okay.

Wrong.  As soon as Juan closes the door behind him, he goes ballistic.  It was like he remembered what he was there for.  "You fucking [this], I'm going to fucking [that]!" and etc.  Whereas before he was waving the gun around, now he kept his arm locked, gun pointing towards the floor.  He's still yelling, cursing, threatening.  The gun is there and it's pointing down and it's simply waiting for him to decide to raise it.

Again, even if the doctor could disarm him, he can't because of the desk.  He can't throw anything, there's nothing else on the desk.  He can't run.  If he stands up, he'll get shot in the chest.  If he ducks down, it forces Juan to lean over the desk, which means he'll get shot in the back of the head or the spine.  

This was the plan: turn to the side and let him shoot him in the shoulder or arm. 

What did he think about?  He thought about his kids, how sad they'd be that their father was dead.  They would cry.   He thought about how this nut would eventually get caught and the kids would have to face the man who did it and listen to his words and the words of everyone else.  The kids would have to look around at an insane world that tried to explain everything with lies.  And then they'd have to go home and grow up.  "That's life," someone would tell them, because it's true and that helps.

He also thought about how stupid this guy was, how terrible he was at valuing things, he had decided that his life was worth throwing away over... what?   He wasn't stealing his car, there wasn't anything of value at stake.   Xanax?  He could have gotten it anywhere else, easily, anytime.  Revenge?  It wasn't like the doctor had raped his sister, he had just not given him something.  But somehow in his calculus this grudge was worth carrying for three months, worth killing someone over, worth 25 years in jail.  This wasn't psychosis, this was a man who was bad at math.

The plan is to give him the shoulder, take it in the shoulder, and not turn, not go down.  

Then the woman comes BACK.  What caused this woman to come back is unknowable, but she opens the door and it bumps him because he's in front of it.  So he turns around to see who's coming in and he grabs the paper out of her hand and he sort of flings it at the doctor. 

But everything is different now, because the door is wide open, and everyone in the waiting room can see them. 

So the doctor, as calmly and with as much authority as he can muster, looks at the paper and says "ok, I can give you 30 tablets of Klonopin with this."  He tried to make it sound like that was what they had been talking about the whole time, a treatment, a transaction.  It wasn't about the doctor, it was about the pills. 

Juan reflexively says, "no, Xanax," and the doctor responds, "no, all I can give you without a urine (drug test) is Klonopin," and Jaun says, "I want 90 of them."  And the doctor says, "only after the urine."

Whatever calm exterior he displayed was not mirrored on the inside, and while he was trying to show steady penmanship he made a mistake- and he wrote Xanax instead of Klonopin.   It just came out.  So now Juan sees the doctor writing that, and the doctor has to decide if he was going to give it to him that way or not.   But if the reason he was still alive was that he had turned it from something personal into a treatment, then handing him the Xanax was an admission that it was, after all, not a treatment but a stick up.  And maybe that would remind Juan that the doctor had screwed him the first time.  So the doctor says, out loud,  "dammit," tears up the script and rewrites it.  Doing the job correctly. 

Juan took it, made a few more threats, and left.  20 minutes after that the police finally came, and while they were there he called the clinic and said he was coming back to kill the doctor because he only got 30 tablets.  A man who is terrible at math.

When the doctor went back to see the patients who stuck around, all of them, men and women, told him the same thing: "Yo, man, I had your back, if anything happened, I was going to bust in here."  Of course they would have.

What's unsettling, however, is that Juan had been in the waiting room for an hour before the doctor even got there, muttering to other people that he was going to "fuck him up."  But no one said anything.

There's not much more to the story, except that the doctor went home, felt a little shaken, had a drink or three, debriefed with some people and not with others, and eventually 3am came and he went to bed.  And when he woke up it was gone, merely a memory, it all felt like it happened a decade ago.  That's life.







Comments

It's about respect. And gan... (Below threshold)

March 23, 2011 8:14 PM | Posted by S: | Reply

It's about respect. And gangbangers simply get more respect from their homeboys when they go to prison -- it means they're not afraid. They'll do anything to prove it. It's not bad at math. It's a different value set than you have, he was handed it at birth, and instead of trading it in for a new one, he just kept going.

White people are no different.

Though I gotta say. It's pretty funny what a gangbanger will do to prove he's not afraid of sticking up for himself by any means necessary, but he's too afraid to live without xanax.

Vote up Vote down Report this comment Score: -3 (45 votes cast)
interesting. is this story ... (Below threshold)

March 23, 2011 8:31 PM | Posted by Anonymous: | Reply

interesting. is this story based on anything in particular, or is it just an instructive tale, like one of aesop's fables?

you know tlp, you occasionally take a jab at your writing skills, but i've always really enjoyed your writing.

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"This wasn't psychosis, thi... (Below threshold)

March 23, 2011 9:01 PM | Posted by FuncDegen: | Reply

"This wasn't psychosis, this was a man who was bad at math."
That cracked me up.

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THAT is how you write a sho... (Below threshold)

March 23, 2011 9:11 PM | Posted by Ryan: | Reply

THAT is how you write a short story. Your description of the room is perfect. All the necessary imagery and background is there to put the reader into the scene, but there's nothing extraneous. Your writing flows very much like Chuck Palahniuk's.

It sounds like this happened to you. If so, good job not getting shot. Too bad you had a waiting room full of human garbage.

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Jeez, I like that better th... (Below threshold)

March 23, 2011 9:33 PM | Posted by Dan Dravot: | Reply

Jeez, I like that better than all the hermeneutical-semiotic stuff. Especially because you didn't say at the end "Surprise! This was really about the Treaty of Rapallo! And Lindsay Lohan!" Ha ha.

Srsly really good post.

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Huh, <a href="http://gawker... (Below threshold)

March 23, 2011 9:38 PM | Posted by Dan Dravot: | Reply

Huh, lookit that, bloody loco.

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Can I make a short film out... (Below threshold)

March 23, 2011 9:42 PM | Posted by Cartaxo: | Reply

Can I make a short film out of this?
I mean it. E-mail me if your answer is Yes.

And I'd like you to delete this comment after you read it.

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It's bad enough when someon... (Below threshold)

March 23, 2011 9:55 PM | Posted by Anonymous: | Reply

It's bad enough when someone doesn't realize how their actions affect others, but when they can't even fathom how they affect themselves -- look out.

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Sounds like you needed to u... (Below threshold)

March 23, 2011 10:35 PM | Posted by Anonymous: | Reply

Sounds like you needed to up his Xanax dose. He needs something calming.

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Glad you made it out. Sound... (Below threshold)

March 23, 2011 11:17 PM | Posted by Max: | Reply

Glad you made it out. Sounds like those rooms need trapdoors!

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What strikes me the most in... (Below threshold)

March 24, 2011 12:02 AM | Posted by Alison: | Reply

What strikes me the most in this story is the interplay of scripts. The protagonist feels like he's participating in a script from a gangster movie. All of us have movie scenes or even entire movies that we can recite from memory. We may fantasize what it would be like to be in that movie. It would seem that the scripts that we follow every day, though, are much more powerful. Handing over an insurance card, haggling for what we want but accepting a much less satisfying compromise, waiting for paperwork in a public place--that script does not need memorization, it's the default script. In a similar way that the ride to work is automatic and taking the same road to a different destination requires concentration, the gangster movie script would take a lot of effort to maintain. Consciously, the doctor is trying to figure out what his "movie script" options are: Jump over the desk? Throw something? He ultimately regains control with the default, "Well, I can give you another medication, but I need your insurance card." script. It's brilliant that the secretary came back into the office--in keeping with the "normal day at doctor's office" script. If she hadn't returned, and Juan realized that she might have called the police, he would have a clear path back onto the gangster movie script.

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Damn alone, that is some cr... (Below threshold)

March 24, 2011 12:28 AM | Posted by Anonymous: | Reply

Damn alone, that is some crazy shit. Going to re-arrange your office now?

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The following story is f... (Below threshold)

March 24, 2011 12:40 AM | Posted by Pemulis: | Reply

The following story is fiction. Any similarity to people living or dead is purely coincidental.

Yeah, sure. Glad you're okay, man.

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I follow you on twitter and... (Below threshold)

March 24, 2011 1:04 AM | Posted by nthomas: | Reply

I follow you on twitter and I'm pretty sure this really happened to you. I'm sorry you experienced this but I'm relieved you are unscathed. Take care of yourself, man.

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"there's no billing code fo... (Below threshold)

March 24, 2011 6:17 AM | Posted by Anonymous: | Reply

"there's no billing code for "pissed off xanax seeking guy.""

I've the solution to that! Just 296' him and call it a day. Clearly a manic, right.

Question: while all this is going on in the office why has no one in the waiting room dialed 911 like their hands are on fire 4 serious? It is hard to believe that no one heard this crazy lunatic screaming, and cell phones are ubiquitous you know.
The behavior of the secretary is unbelievable. Like she is a non-thinking drone who makes a copy and then walks back into the office to give it to the doctor, even when there is a crazed lunatic with a gun? What? Is this how doctors think of those who work for them? LOL. Oh boyez, as a nurse I knew how docs tended to think but is it really that bad?
"The doctor asked for this paper so I better go to the copy machine and do it now, even though there is a crazy guy threatening to kill people, I'm going to make this copy and go give it to him because I have no ability to think independently or make a decision or demonstrate even basic reflexive survival skills"
But yea, the story is interesting , it's just flat, the behavior of the people involved has no depth.

This cannot be a real account of something that happened to alone because it's completely unrealistic. If I was a pissed off xanax seeker I would go to a pharmacy and threaten those people - walking out with a bag of oxycontin and xanax, hopefully. Threatening a doctor to give you a script for xanax is doomed to fail. You do have to take the script to a pharmacy, which then must be called back to the doc's office. You'll be caught in no-time at all. It's like wearing a tracking device that says "arrest me here, plz" once you try to actually use the script.
IEither the guy was mentally ill for serious and didn't realize how foolish and illogical this behavior was (which means the psychiatrists assessment of him as sane is grossly incorrect), or alternatively this did not happen. No sane, rational person threatens an MD for a script because they want xanax that bad. It makes way more sense to attempt to hold up a pharmacy (thats probably doomed to fail as well but at least it is a rational behavior). Anyone with a working brain knows that a script must be authorized and taken to a pharmacy.

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I do think this may have be... (Below threshold)

March 24, 2011 6:20 AM | Posted by Anonymous: | Reply

I do think this may have been inspired by a real life event. Sounds like some inner city thug may have yelled at alone about his xanax.
He's probably not used to seeing dark people, especially when they are yelling.

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Glad to hear you came out O... (Below threshold)

March 24, 2011 6:49 AM | Posted by fraula: | Reply

Glad to hear you came out OK.

Sounds like the nurse held on to your instructions as a sort of life raft in a sea of inconceivable, unreal (to her) events. I've noticed that sort of reaction in people who've never had to deal with violence or threats of it on a person-to-person level (they either had someone else protecting them, or just never experienced it at all).

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The story is good, but you ... (Below threshold)

March 24, 2011 9:03 AM | Posted by Gene Callahan: | Reply

The story is good, but you really need copy editing.

Vote up Vote down Report this comment Score: -2 (6 votes cast)
50 mg Intraocular injection... (Below threshold)

March 24, 2011 9:46 AM | Posted by Parthicus: | Reply

50 mg Intraocular injection vitamin H stat

Vote up Vote down Report this comment Score: 0 (2 votes cast)
50 mg Intraocular injection... (Below threshold)

March 24, 2011 9:47 AM | Posted by Parthicus: | Reply

50 mg Intraocular injection vitamin H stat

Vote up Vote down Report this comment Score: 0 (2 votes cast)
Very nice. Reads like a 50s... (Below threshold)

March 24, 2011 12:23 PM | Posted by Anonymous: | Reply

Very nice. Reads like a 50s radio show, substituting the doctor for the PI.

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Oh God. Another young and i... (Below threshold)

March 24, 2011 1:02 PM | Posted, in reply to Ryan's comment, by Anonymous: | Reply

Oh God. Another young and insecure wannabe attempting to fit in by mentioning Chuck. PUHLEEASE!

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The following story is f... (Below threshold)

March 24, 2011 1:06 PM | Posted by butterflymcdoom: | Reply

The following story is fiction. Any similarity to people living or dead is purely coincidental.

And yet, judging by the comments, it's a common assumption that it really happened, specifically to Alone. Why? Is it because he overtly denies it's true at the outset?

Maybe it is as simple as that. But I like to think that Alone works a more subtle magic than that.

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Alone. You might have a kna... (Below threshold)

March 24, 2011 2:31 PM | Posted by Aikou: | Reply

Alone. You might have a knack for dissecting phenomena of popular culture and the sciences, your media critique is definitely insightful--but this is why I keep coming back. Your short stories are absolutely brilliant, captivating and, even in their occasional banality, so intense that one finds themselves wanting to believe they're real. Kudos!

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TLP, great post and glad to... (Below threshold)

March 24, 2011 3:21 PM | Posted by Andrew: | Reply

TLP, great post and glad to hear everything is alright.

butterflymcdoom: there's a simpler explanation, check the Twitters (@thelastpsych).

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Take a look at his twitter ... (Below threshold)

March 24, 2011 3:43 PM | Posted, in reply to Anonymous's comment, by Ryan: | Reply

Take a look at his twitter @lastpsych, March 19. It's entirely possible that he's just trying to everyone that someone tried to kill him, but that seems very unlikely to me. He hasn't tried to sell any of his other short stories as real that way.

You're right, the man's behavior is irrational. Like TLP said: he's bad at math. People, most people, don't behave the way you want them to behave in emergency situations.

Again, TLP: glad you're okay. Take a vacation?

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All that just for Xa... (Below threshold)

March 24, 2011 4:23 PM | Posted by DOB: | Reply


All that just for Xanax? You can buy Xanax on the street in any big city, and if you have a gun you stand a good chance of getting it for free. You could even "casually notice" somebody getting a prescription filled and then jump out from a doorway.

I get worried at the drugstore in bad neighborhoods because some people crush Wellbutrin and snort it for the buzz (though for some reason I've never tried that myself). And that's because I'd have a hard time convincing the shrink and the pharmacist that it really got stolen; they'd think I sold it or maybe I was stocking up for a suicide attempt. (Suicide by Wellbutrin overdose doesn't sound like fun to me but there are some suicidal people who actually hate themselves.)

"Bad at math" doesn't come close: that description fits a TOTAL MORON.

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Tee hee that's what i'm thi... (Below threshold)

March 24, 2011 5:34 PM | Posted, in reply to Parthicus's comment, by Anonymous: | Reply

Tee hee that's what i'm thinking.
But alone describes him as "sane" so it ain't happening. Hard to believe a person who was sane and not psychotic would act this way, it shows no rational thought processes. "So now I am going to threaten to kill a doctor, take my xanax script to walgreens, and enjoy my xanax heaven, yay!" I mean even a retarded thug realizes he'll get caught when he tries to use the script.

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Hi, I made the above commen... (Below threshold)

March 24, 2011 5:48 PM | Posted by Cartaxo: | Reply

Hi, I made the above comment about making a short film and got -11 score out of 11 votes.

Can you people please tell me what's so wrong about finding an insteresting story and thinking it might be good material for a short-film?

I'm an actual filmmaker, it's my craft.

As for asking for the comment to be deleted, that was because it was not really a comment on the subject of the post, it was just me trying to communicate with the author of this blog, and I don't know any other way to do so.

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You can email TheLastPsych ... (Below threshold)

March 24, 2011 7:18 PM | Posted, in reply to Cartaxo's comment, by Ryan: | Reply

You can email TheLastPsych at the address listed on his "about" page, located on the right hand side of this page. He also has a Twitter account. I hope this helps.

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Psychiatrist vs. gun <a hre... (Below threshold)

March 24, 2011 9:40 PM | Posted by Anonymous: | Reply

Psychiatrist vs. gun http://bit.ly/fmNdhj a work of fiction. #allofthishashappenedbeforeanditwillhappenagain March-23-11 8:07:16 PM via web

# Pretty much was certain I was going to get killed. A little scared. Over now. I wrote a movie review on one of the blogs. March-19-11 6:41:42 PM via web

# First time,ever:patient tried to kill me. Gun/locked my door/everyone ran #allofthishashappenedbeforeanditwillhappenagain Need whiskey.
March-19-11 3:26:24 PM via web

I don`t know what to believe.

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Whether or not it actually ... (Below threshold)

March 25, 2011 12:37 PM | Posted by Reader: | Reply

Whether or not it actually happened is kind of tangential (sidenote: Alone doesn't come off as the type of blogger to run a 4 day ruse to hype a post, they're inflammatory enough without made up death threats.)

I'd like to know wtf was up with him. Bad at math, yeah, bad with stereotypes, yeah, but walking into a crowded psych's office with a gun still isn't accounted for by (1) and (2).

The guy isn't a criminal. If he were a criminal, he would have asked Juan Numero Dos from the corner to hook him up. He's probably poor, since if he had cash he would have told the doctor to fuck the insurance, he'd be paying out of pocket. And he probably doesn't have a history of anger issues, considering he waited in the front room for an hour rather than just barging in.

When House ran this cliche the guy wanted an answer. So...what was Juan's deal? What's his story?

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Some of the responses here ... (Below threshold)

March 25, 2011 12:56 PM | Posted by Anonymous: | Reply

Some of the responses here are ridiculous. Is TLP making this up? Possibly. Does that mean it can't happen? Hell no.

Try checking out a psychiatric clinic in Liberty City Miami or North Philadelphia and tell me this can't happen.

Try finding a nurse and/or secretary who wants to work in one of these clinics. I'm sure the line will be out the door. /sarcasm

The entire point of the article is that the gun waver is bad at math aka, he's not smart enough to realize his actions are stupid and he could probably just buy xanies on the street/he'll get thrown in jail over something stupid. You're thinking from the perspective of yourself, not a gangbanger who is in and out of prison like you are in and out of Starbucks. He doesn't think from the same cost-benefit analysis you've outlined because he's not you. He doesn't logically draw out his conclusions and factor in risk and reward. If he could do that, why would he be in a gang?

Anyway, xanies are usually cheaper from the pharmacy, especially if SSI helps pay for them.

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"... What's unsettling, how... (Below threshold)

March 25, 2011 2:09 PM | Posted by Jess: | Reply

"... What's unsettling, however, is that Juan had been in the waiting room for an hour before the doctor even got there, muttering to other people that he was going to "fuck him up." But no one said anything..."

That's a little more than unsettling.

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*raises hand*Oooh ... (Below threshold)

March 26, 2011 1:52 AM | Posted, in reply to Anonymous's comment, by Anonymous: | Reply

*raises hand*

Oooh Oooh I'm a nurse! I'm smart and good at my job! I also wear colorful clothes and makeup so I look cute like a nice flowering plant. My scrubs and accessories are A+. I will be a good addition to any office! Can I work for you? My job sux so badly. I was elected supervisor of all nursez against my will. I do it because its like idiocracy, where I am the last person of normal intelligence in the facility and so in contract everyone treats me like I should be a leader. I'm teaching my coworkers that plants grow with water and not Gatorade. They still don't get it.


Someone rescue me and give me a better job. I will TOTALLY work in an inner city clinic, as long as there is a police escort of course.

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Is this was inspired by a r... (Below threshold)

March 26, 2011 2:22 PM | Posted by SusanC: | Reply

Is this was inspired by a real event, I'm glad Alone got out OK.

I often think the "gatekeeping" aspect of psychiatry is potentially harmful. Typical setup: the patient really wants help, and believes the drug will help them (this belief no doubt reinforced by the psychiatric profession). But they can't just buy it (at least, not legally...). Only the psychiatrist can give it to them. So they have to convince the psychiatrist that they are sick enough, which often involves playing up their suicidal ideation. (Playing up your murderous thoughts might also work, but possibly carries a greater risk of incarceration).

It's kind of like one of Skinner's conditioning experiments, where you reward the subject (by giving them the drug they want) whenever they express suicidal or murderous thoughts. It's also like Festinger's experiments on cognitive dissonance: by making the patient repeatedly play-act that they are suicidal/murderous, they start to believe it.

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P.S. I've never been in a p... (Below threshold)

March 26, 2011 2:51 PM | Posted by SusanC: | Reply

P.S. I've never been in a position to try it myself, but a substantial number of people who are patients tell me that they told their psychiatrist they'd buy the drug they wanted on the black-market if he didn't prescribe it, and this persuaded him to write a prescription. The patient in the story maybe needed to shop around for a more tractable psychiatrist. (And how much is Xanax going to be on the black market anyway? My guess is not very much).

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(this belief no doubt re... (Below threshold)

March 26, 2011 10:02 PM | Posted, in reply to SusanC's comment, by Reader: | Reply

(this belief no doubt reinforced by the psychiatric profession)

Or the media. Or the next door neighbor. Or the nagging wife who sees too many psychiatric medicine commercials while she's watching her soaps.

We've mainstreamed mental illness to the point that anyone can be stressed beyond belief. We drive the point home by playing the advertisements for the medicine(s) in the middle of programs that portray unrealistic human emotions. If only I were taking Xanax, I'd respond to my stressful job the same way John Doe does...(FWIW, I found this hyperbolic documentary on the subject interesting.)

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I'm a therapist at an inner... (Below threshold)

March 27, 2011 1:39 PM | Posted by Anonymous: | Reply

I'm a therapist at an inner city mental health clinic, and this story, minus the gun of course, happens almost weekly.

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LOL.. flowering plant line ... (Below threshold)

March 27, 2011 2:06 PM | Posted, in reply to Anonymous's comment, by Anonymous: | Reply

LOL.. flowering plant line was genius

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I worked for two years as a... (Below threshold)

March 27, 2011 7:17 PM | Posted by Kayode: | Reply

I worked for two years as a pharmacy assistant in a not so great neighborhood, so yeah, some of the clients were pretty 'bad at math.'

"You only gave me my pills for one week!"
"No we're pretty sure you're covered for the month, buddy."

But no one ever came in with a gun... except this one time a guy walks in and hands a note to one of the assistants:

"I want all your dilaudid and i have a gun"

then panic spreads everywhere but before we could give him what he wanted he got scared, thinking someone had called the cops already so he ran. No one was hurt but we never found out whether he really did have a gun or not.

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Jess,The folks wai... (Below threshold)

March 30, 2011 1:33 PM | Posted, in reply to Jess's comment, by Jack Coupal: | Reply

Jess,

The folks waiting to see the doctor saw Juan's antics in the waiting room. What if any patient there had decided to "tell someone" before the event went down? The thought that Juan probably had a hidden gun or knife for doctor persuasion made them blend into the wallpaper instead. Had Juan received his Xanax, he could easily have punished the snitcher on his way out. Better to bury one's head in the 1987 issue of Newsweek.

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Maybe the doctor is a hero.... (Below threshold)

March 31, 2011 4:50 AM | Posted by Anonymous: | Reply

Maybe the doctor is a hero...

Unless he also wrote the narrative.

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Great post. I appreciate yo... (Below threshold)

April 1, 2011 2:20 AM | Posted by nike air max: | Reply

Great post. I appreciate you bringing this forward.

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Classic. Female nurse is to... (Below threshold)

April 3, 2011 2:57 PM | Posted by Anonymous: | Reply

Classic. Female nurse is too stupid to do the obvious; escape the office per your instructions and call that police. I bet she is "bad at math" too.

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Great story. Such story hap... (Below threshold)

April 11, 2011 3:50 AM | Posted by free barcode software: | Reply

Great story. Such story happened so often but one need to understand that his small mistake can actually create problems for other.

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Depressing.I was r... (Below threshold)

June 17, 2011 2:18 AM | Posted by S: | Reply

Depressing.

I was raised to step up and actually do something in a situation like that, and I have. Sometimes it's been someone larger than me; once it was a knife; I hope it's never a gun, because then we'll figure out just how tough I really am - and it's probably not tough enough.

How can people just sit idle and do nothing like that?

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"What's unsettling, however... (Below threshold)

July 26, 2011 7:28 PM | Posted by L'enfant Terrible: | Reply

"What's unsettling, however, is that Juan had been in the waiting room for an hour before the doctor even got there, muttering to other people that he was going to "fuck him up." But no one said anything."

Oh come on. They hear exactly that kind of stuff every single day in every one of the endless succession of waiting room they sit in. Scarcely ever does it pan out. Are you really so unfamiliar with the culture? With the patois? Of course not. You know they can't be blamed.

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Your analysis does get in t... (Below threshold)

December 28, 2011 7:11 PM | Posted by Anonymous: | Reply

Your analysis does get in the way of the story (and vice versa), all the explaining you do about some of the subtleties. You have two good things here, an analysis piece and a short story; they're just tangled together.

I love your analysis in general, by the way, especially the narcissism theme. I feel like understanding that has helped me. You like to take current issues and dissect them, exposing the problems. It's entertaining, and useful, but it'd be great to see you speculate about some solutions.

I feel like the occasional case discussion, or an actual topic here or there about the field and practice of psychiatry, would be really interesting.

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The man wanted justice</... (Below threshold)

July 21, 2012 10:34 AM | Posted by jonny: | Reply

The man wanted justice.

This is a uniquely religious emotion. Insane, like all religious emotions. Our entire judicial system is as insane as this man. And just as bad at math.

"eye for an eye, tooth for a tooth"

2 + 2 = 4 instances of insanity. Our judicial system thinks the answer is 0, or 1.

justice = revenge = insult

This man felt he had been the victim of a wrong. He had suffered an injury in his mind. He wanted to right the wrong. He was insulted that the doctor would play him.

Why did the Herr Doctor not give the man what he wanted? It's almost always a good idea to converse with the religiously insane in the language they understand; religious illusional emotions. An apology, for the error. Remorse, for the suffering imagined in his mind. Mitigation, because it was not intentional of course; you would reveal something embarrassing and private so that he knows you are being genuine. You weren't yourself that day, you had just found out your wife had been unfaithful. Penitence, because at the end of the day, there's no excuse for having been the unintentional cause of his suffering. You're a professional, you might point out he deserved better. You shouldn't have let your personal life affect your professional career, but you really loved her and you're really struggling emotionally. He sounds like a man who might empathise. Still, you'd be contrite. You would appeal to his religious sensibilities, and request he accept your heartfelt apology and ask him to forgive you.

He just wants a little respect. He's tired of being taken advantage of. You would ask him what you can do to remedy the injustice. Does it matter if the Doc scribbles 90 Xanax down? The police are going to be picking him up shortly, no?

I dunno. I just know how to handle religiously insane people. I had a lot of practice as a child. They're all just tired of being treated as if they were a fool. They are certain everyone is mocking them, rolling their eyes at them, avoiding them, treating them like an outcast, and then they snap when they've simply had enough! In his mind, you were the final straw. He felt he had to draw a line in the sand. Enough is enough!

I think if he wanted to kill the Doc, he'd have barged in rather than wait his turn. This sounds like a man with a very religious sense of fairness. I can't help but feel this man merely wanted redress.

Tight creeps in the waiting room. Everyone had the survivor's back after the fact. I've seen that phenomenon before.

Glorious writing as always, of course. I'd exchange my firstborn MALE child to write like that.

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Do you have your own blog? ... (Below threshold)

February 14, 2013 2:25 PM | Posted, in reply to jonny's comment, by kdetx: | Reply

Do you have your own blog? If not, you should.

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